Minimally invasive spine surgery instruments: guide wire handle with a guide wire locking mechanism

ABSTRACT

Disclosed are various instruments and implants used in minimally invasive spine surgery. Disclosed is a cannulated probe, a guide wire handle; a guide wire handle having a locking mechanism, an all-in-one guide wire tool; a retractor flex rod passage; or a tab break tool.

CROSS REFERENCE TO RELATED APPLICATION

In accordance with 37 C.F.R. 1.76, a claim of priority is included in anApplication Data Sheet filed concurrently herewith. Accordingly, thepresent invention claims priority to U.S. Provisional Patent ApplicationNo. 61/704,132, entitled “MINIMALLY INVASIVE SPINE SURGERY INSTRUMENTS”,filed Sep. 21, 2012. The contents of which the above referencedapplication is incorporated herein by reference.

FIELD OF THE INVENTION

This invention relates to instruments and implants used to treat variousproblems of the spine.

DESCRIPTION OF THE PRIOR ART

Minimally invasive spine surgery can be used to effectively treatdisorders of the spinal discs with minimal muscle related injury. Inmany procedures, a surgeon makes several small incisions (percutaneous)wherein a miniature camera (usually a laparoscope or endoscope) isplaced so the surgeon can view the procedure as a magnified image onvideo monitors in the operating room. Specialized instruments are placedthrough the incisions to perform various procedures. Minimally invasivespine surgery may include: Spinal fusion such as on degenerative disks;deformity corrections, such as for scoliosis; repair of herniated disks;repair and stabilization of vertebral compression fractures anddecompression of spinal tumors to name a few. In certain cases ofdegenerative discs, scoliosis, kyphosis, spinal column tumors,infection, fractures and herniated discs, minimally invasive techniquesmay speed recovery, minimize post-operative pain and improve the finaloutcome.

SUMMARY OF THE PRESENT INVENTION

The inventions disclosed are directed to various instruments andimplants used in minimally invasive spine surgery. Disclosed is: acannulated probe, a guide wire handle; guide wire handle having guidewire locking mechanism, an all-in-one guide wire tool; a retractor flexrod passage; a tab break tool; a modular screw head; a flange rod; and aperc rod inserter.

Objectives, advantages and benefits associated with these inventionswill be apparent to those skilled in the art from the description anddrawings which follow.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a cannulated probe embodiment;

FIG. 2 is perspective view of the cannulated probe in FIG. 1 with thehandle detached;

FIG. 3 is a perspective view of the cannulated probe in FIG. 1 stylus;

FIG. 4 is an enlarged view of the cannulated probe in FIG. 1 distal tip;

FIG. 5 is a perspective view of a guide wire embodiment;

FIG. 6 is a cross sectional view of the guide wire handle in FIG. 5 in araised position;

FIG. 7 is a cross sectional view of the guide wire handle in FIG. 5 in alowered position;

FIG. 8 is a perspective view of an all-in-one guide wire toolembodiment;

FIG. 9 is a perspective view of the guide wire tool in FIG. 8 depictingthe protective sleeve without the flex cover;

FIG. 10 is a perspective view of the guide wire tool in FIG. 8 depictingthe bone tap;

FIG. 11 is a perspective view of the guide wire tool in FIG. 8 depictingthe guide housing;

FIG. 12 is a perspective view of the guide wire tool in FIG. 8 depictingthe protective sleeve;

FIG. 13 is a perspective view of the guide wire tool in FIG. 8 depictingthe expandable dilator;

FIG. 14 is a perspective view of the guide wire tool in FIG. 8 depictingthe assembly of the expandable dilator over the protective sleeve;

FIG. 15 is a pictorial view of the guide wire tool in FIG. 8 depictingthe dilator sleeve in an expanded position;

FIG. 16 is a perspective view of a retractor flex rod passageembodiment;

FIG. 17 is a perspective view of a tab break tool embodiment for aretractor;

FIG. 18 is an enlarged view of the cam used in the tab break illustratedin FIG. 17;

FIG. 19 is an enlarged view of the shaft lock used in the tab break toolillustrated in FIG. 17;

FIG. 20 is a an illustrative embodiment of a guide wire managementsystem adapted to control the position of a guide wire during theinsertion of various hole creating devices and/or screws using a lockingmechanism;

FIG. 21 illustrates the locking mechanism shown in FIG. 20;

FIG. 22 illustrates an alternative view of the locking mechanism shownin FIG. 20;

FIG. 23 illustrates an alternative view of the locking mechanism shownin FIG. 20;

FIG. 24 is a cross sectional view of the guide wire management system;

FIG. 25 is a cross sectional view of the guide wire lock in the open,non-locking position;

FIG. 26 is a cross sectional view of the guide wire lock in the closed,locked position;

FIG. 27 illustrates the guide wire management system engaged with avertebral body; and

FIG. 28 illustrates an alternative view of the guide wire managementsystem engaged with a vertebral body.

DETAILED DESCRIPTION OF THE INVENTION

Referring to FIGS. 1-4, set forth is a cannulated probe 10 having ahandle 12, a shaft 14, stylus cap 16 and stylus 18. The shaft 14 has anupper section 20 made of a radiolucent material and a lower section 22made of a radio opaque material. The lower section 22 includinggraduated markings 26. Unique to this invention is the ability to removethe handle 12 wherein an uninterrupted viewing of along the length ofthe shaft from above the now displaced handle is made possible. Thehandle made from a low cost material that would otherwise disruptimaging. The stylus 18 can be reinserted into the shaft 14 without thehandle. The radiolucent shaft with a radiopaque tip is unique and couldbe adapted to a variety of pedicle prep instruments including Jam shidi,awl, tap and so forth.

FIGS. 5-7 depict a guide wire handle 50 having a shank 52, a handle 54 aguide wire capture handle 56 and a guide wire 58. The guide wire tool isused to control the position of a guide wire during insertion. The guidewire 58 can be held in the exact position by use of the guide wirecapture handle 56. The capture handle 56 include a threaded rod 60 thatengages an upper end of the handle 54 wherein rotation of the handle 54in relation to the guide wire capture handle 56 allows rotation of thebone tap screw thread 62 have the exact same thread pitch movement. Inthis manner, rotation of the bone tap screw 62 is possible withoutmovement of the guide wire 58. In the preferred embodiment, not shown,the guide wire capture handle may include a lever to allow for ease ofengaging the guide wire. The screw depth can be measured from the guidewire handle. In another embodiment, the treaded rod and the tap screwthread are not matching threads but have a positioning shaft and anexternal engagement between the clamp on the wire and a fixed position,such as on the bed clamp. This device could be used during screwinsertion and removal, tap insertion and removal to ensure the wire doesnot advance forward nor retreat back. The device could also be used todrive a wire forward in a controlled measurable manner.

Referring now to FIGS. 8-15, set forth is an all-in-one guide wire tool100 formed from a shank 102, having a central passageway for a guidewire 104. The instrument allows for a single step dilation. The shank102 includes a protective sleeve 106 with a expandable dilator 108.Handle 110 with guide handle 112. At the bottom of the shank 102 is abone tap 114 and awl 116. The expandable dilator 108 having a serratedend 120 that expands upon the insertion of the sleeve 106 and retractsto the original position upon removal of the sleeve 106. The handle 110may be used as a hammer or engaged with bone tap for ease of rotation. Aunique feature to this embodiment being that in a single pass thesurgeon is able to take the steps of an awl, jamshidi, guide wireplacement and tap. The instrument uses the guide wire handle describedabove to ensure the guide wire position.

Referring now to FIG. 16 is a perspective view of a flex rod passage 150screw-based device for use in minimally invasive surgery. The device isdefined by a modular screw head 152 have a malleable zone 154 locatedabove a break line 156. The malleable zone 154 allows the material toflex for ease of rod positioning. A non-ridged zone 158 is positionedabove the malleable zone allowing blades 160 and 162 to be split apartthereby retracting of the soft tissue and allowing the surgeon tomaintain a clear view of the operating site. In the preferredembodiment, the retractor is made from titanium, titanium alloy,surgical steel or the like material having properties that allow for amalleable zone that can be bent in a hinge like manner, and stay in thebent position until further movement by the surgeon. The material allowsthe blades to be placed in a position that allows the surgeon ease ofaccess through the incision, the malleable zone 154 having score slotsconstructed and arranged to allow for bending of the blades which willstay in position until further moved. The malleable feature may also beused for soft tissue retraction during interbody placement ordecompression work. In this scenario, the tabs would likely be bent inthe same direction to provide a cephalad caudal retraction.

Referring not to FIGS. 17-19, set forth is a perspective view of a tabbreak tool 200 for a retractor. The tool includes a cam 202 that isconstructed and arranged to be placed adjacent to a break line 204 of aretractor shown in FIG. 16. An outer sleeve 206 is slidably positionedto the outside of the blades 208 of the retractor. Rotation of the cam202 operates to shear the blades 208 along the break line 204. The outersleeve 206 includes positioning edge 210 that partially encompasses arod 212 to prevent rotation of the outer sleeve 206. Handle 214 issecured to a shaft 216 having engagement tab 218 positionable withinslot 220 formed in the outer sleeve 206 for use in rotation.

Referring to FIG. 20, an alternative embodiment of the guide wiremanagement system, similar to the embodiment described with handle 50 isshown. The guide wire management system, referred to generally as 400,is constructed to control the position of a guide wire during theinsertion of various hole creating devices and or screws. The guide wiremanagement system 400 includes a handle 402 and a cannulated body 404.The handle 402 includes a handle body 406, a first end 408 and a secondopposing end 410. The first end 408 is adapted to secure or couple tothe first end 412 of the cannulated body 404. A second end 414 of thecannulated body 404 is adapted to secure to a bone tap screw thread 416.The handle 402 further includes a guide wire locking mechanism,illustrated herein as a guide wire locking 418 which allows a user tolock or maintain a guide wire 420 in place, thereby preventing the guidewire 420 from rotational movement.

The use of a guide wire locking mechanism 418 offers several advantagesduring use in an operation. Guide wires are a common technique forplacing cannulated bone screws into the pedicles of the spine. In thistechnique the surgeon will use a cannulated (i.e. a Jam Sheidi)instrument to identify and create the intended path for the screw to beplaced. Once the path is created the surgeon will place a guide wirethrough the cannula and remove it leaving the guide wire behind as aguide for additional hole preparation instruments such as a drill and orbone tap and eventually bone screw. It is critical that the guide wirenot be inadvertently advanced or removed during the entire preparationand screw insertion process. Typically, the surgeon will have anassistant manually hold the extension of wire protruding through theback of the instrument handle in an effort to control the position ofthe wire. This can present obstruction to the surgeon and is prone tohuman error. The guide wire management system 400 incorporates a guidewire locking mechanism in the handle which maintains the wire inposition during the entire preparation and screw insertion process.

Referring to FIGS. 21-23, an illustrative embodiment of the guide wirelock 418 is shown. The guide wire lock 418 contains an a body 422storing the internal locking mechanism, such as using a cam lock lever,for securing the guide wire 420 in place therein. A male threadedextension 424 extends from the body 422 and is used to communicate orcouple with female threading 426 associated with the handle 402.Preferably, the threaded extension 424 has a thread pitch equal to thatof the bone tap and bone screw pitch so when the cam locking mechanismis held stationary as the instrument handle 402 is advanced, the wirewill maintain its position in space. The treaded extension 424 may alsoincorporate a scale, or positional markings 428 to identify the distancetraveled from the starting position, thereby aiding the user indetermining the depth of insertion during operation of the device.

FIGS. 24-26 are cross-sectional views of the guide wire managementsystem 400, see FIG. 24, or the guide wire lock 418 in an open position,see FIG. 25 or closed position, see FIG. 26. The guide wire lock 418comprises a cam lock lever 428 which rotates about pivot point uponmanipulation a user. In the open position, i.e. the guide wire 420 isnot locked in position, the guide wire is not engaged with a detent orrecessed portion 430 positioned within the within the body 422. As auser actuates the cam lock lever 428, a cam 432 moves in a liner mannerrelative to the guide wire 420, pinching the portion of the guide wire420 that overlays or rests above the detent or recessed portion 430therein. In this position, the cam lock lever 428 maintains a portion ofthe guide wire within the detent or recessed portion 430 until releasedback to open position, preventing the guide wire 420 from rotational, orlinear (i.e. movement along the longitudinal axis of the handle, lockingit in place.

When inserted into a vertebral body 434, see FIGS. 27 and 28, the guidewire 420 can be held in the exact position by use of the guide wire lock418. When the threaded extension 424 that engages an upper end of thehandle 402, rotation of the handle 402 in relation to the guide wirelock 418 allows rotation of the bone tap screw thread 416 to have theexact same thread pitch movement. In this manner, rotation of the bonetap screw 416 is possible without movement of the guide wire 420. Thisdevice could be used during screw insertion and removal, tap insertionand removal to ensure the wire does not advance forward nor retreatback. The device could also be used to drive a wire forward in acontrolled measurable manner.

Detailed embodiments of the instant invention are disclosed herein,however, it is to be understood that the disclosed embodiments aremerely exemplary of the invention, which may be embodied in variousforms. Therefore, specific functional and structural details disclosedherein are not to be interpreted as limiting, but merely as a basis forthe claims and as a representation basis for teaching one skilled in theart to variously employ the present invention in virtually anyappropriately detailed structure.

All patents and publications mentioned in this specification areindicative of the levels of those skilled in the art to which theinvention pertains. All patents and publications are herein incorporatedby reference to the same extent as if each individual publication wasspecifically and individually indicated to be incorporated by reference.

It is to be understood that while a certain form of the invention isillustrated, it is not to be limited to the specific form or arrangementherein described and shown. It will be apparent to those skilled in theart that various changes may be made without departing from the scope ofthe invention and the invention is not to be considered limited to whatis shown and described in the specification and any drawings/figuresincluded herein.

One skilled in the art will readily appreciate that the presentinvention is well adapted to carry out the objectives and obtain theends and advantages mentioned, as well as those inherent therein. Theembodiments, methods, procedures and techniques described herein arepresently representative of the preferred embodiments, are intended tobe exemplary and are not intended as limitations on the scope. Changestherein and other uses will occur to those skilled in the art which areencompassed within the spirit of the invention and are defined by thescope of the appended claims. Although the invention has been describedin connection with specific preferred embodiments, it should beunderstood that the invention as claimed should not be unduly limited tosuch specific embodiments. Indeed, various modifications of thedescribed modes for carrying out the invention which are obvious tothose skilled in the art are intended to be within the scope of thefollowing claims.

What is claimed is:
 1. A guide wire management system adapted to control the position of a guide wire during the insertion of various hole creating devices and/or screws comprising a handle, cannulated body, and a device for insertion into a vertebral body.
 2. The guide wire management system adapted to control the position of a guide wire during the insertion of various hole creating devices and/or screws according to claim 1 further including a locking member constructed and arranged to maintain a guided wire in stationary position as said handle or said cannulated body is advanced. 